Klevansky, Jason
Klevansky, Jason is an individual health care provider with primary practice located at 3455 Lawrenceville Hwy , Lawrenceville GA 30044-4101. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Klevansky, Jason can be contacted via phone (770) 921-1115.Contact Information
Primary practice address
3455 Lawrenceville Hwy
Lawrenceville GA 30044-4101
Phone: (770) 921-1115
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DS028119L | Pennsylvania |
| Dental Providers / Dentist | 122300000X | DN012805 | Georgia |
Profile Details
| NPI number | 1053315952 |
|---|---|
| LBN Legal business name | Klevansky, Jason |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2005 |
| Last updated | Jul 21st, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053315952 | NPPES |
| Pennsylvania | Other | 157593 | UNITED CONCORDIA |
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